An article appeared today in the New York Times as a followup to a bill passed in New York granting nurse practitioners the right to provide primary care without the oversight of a physician. The authors of the bill state "mandatory collaboration with a physician no longer serves a clinical purpose and reduces much-needed access to primary care". The need for more primary care providers is due to the shortage of primary-care physicians, the aging boomer population, and the Affordable Care Act.
Although the president of the American Association of Nurse Practitioners feels that the current "hierarchical, physician-centric structure" is not necessary, many physicians disagree citing that the clinical importance of the physician's expertise is being underestimated and that the cost-effectiveness of nurse practitioners is being over-estimated.
Many physicians also feel that "nurse practitioners are worthy professionals and are absolutely essential to patient care. But they are not doctors."
What are your thoughts on this? Where do nurse practitioners fit into the healthcare hierarchy?
HotHamWater, whomever you are, you have only lost credibility for your team.
Now, it seems you are only badgering the NPs here that are doing exactly what YOU physicians (or physicians to be) have allowed them to do.
Right, by exposing the hypocrisy and illogical inconsistencies of one of your more droning colleagues, I've lost credibility for my team (save, there is no team here). That makes about as much sense as him demanding, no less than 10 times, that I defend a position that I've yet not taken. "Where's the evidence to support your position!?" Well, if I had taken position, I'd gladly supply, but....alas. Some real, quality reasoning going on there.
However, I'd love a copy of the talking points you guys seem to be reading from, it's great stuff. You guys are machines, it's as if this stuff has been programed into your heads and you push repeat ad nauseum.
I've enjoyed the part about NPs spending more time with their patients. Especially when the NPs are able to do that in a primary care setting because the MDs are working 4 times as hard so that they can keep the lights on in the place. It's as if NPs don't realize that FM docs are limited in their time with patients from without, not within. FM docs don't hate their patients, they aren't choosing to spend less time with them, they are forced by the same bureaucratic nonsense that is giving you guys power. Big hint, big gov. givith and big gov. taketh away. You've made your bed, though.
Keep up your fight for autonomy, you'll quickly learn why there really is only 10-15m per patients in the budget, and heck, with those lower reimbursements rates, you might even be able to half that.
Really not taken a position....I think it is pretty clear from your posts that you have taken a position.
It's as though you have no experience in the real world. In any occupation when someone with a lower degree of experience or education claims that they can do the job of someone with a higher degree of education or experience usually the later is quick to point out the flaws in such reasoning. Namely, the former is inferior and in this case, they are unfortunately unable to see why or how they are inferior.
The multi-step USMLE board exams are the standard to practice medicine in this country. Just like taking a driving exam is the standard to drive a car. If you can't read the signs, you shouldn't have a license to drive.
Your example fails to support your claim. You sited a study showing that physicians are pointing out the obvious differences and inadequacies of the bogus step 3 type exam NPs take. Contrary to your non-point, Physicians would love to see you guys take a real step 3. It's the easiest of the boards and most NPs would be crushed.
Money and egos? Yep, RNs want to become NPs for money and to stroke their egos. You've never been more right then you are right now.
I'm not sure you're clear on the definition of "ignorant". The only person who is lacking information in the argument are those who have never taken the exam. Try harder.
No, it's just one of the many laughable points in the ever increasing claims to equivalency of NPs. "You can't even pass our easiest exam, how do you expect to do our jobs?"
And after these statements you are still claiming you haven't taken a position on NP independence either?
After reading many posts in this thread, I have concluded that NPs are as good or even better than physicians... A moderator should close this thread. End of this discussion!
After reading many posts in this thread, I have concluded that NPs are as good or even better than physicians... A moderator should close this thread. End of this discussion!
Glad you finally came to the right conclusion. See, they can be taught! ;-) haha
Seriously though, I don't think we are ever going to come to an agreement when you have two professions in a micturation contest. Not to be biased but I place more blame on the physicians, let NPs do what they do and respect them as a separate profession that YOU DONT CONTROL. Let the legislature and the public take care of everything else.
Latecomer here, but I saw this post and was so infuriated I have to weigh in. This article presents a poorly justified rationale to cover up fear. Maybe nurses aren't doctors, but who says primary care can best be provided by doctors? I don't think this person represents the increasingly more mainstream view: non-doctors are filling a vacuum of primary care left by fleeing MDs--and filling it well. I don't want to spend the time ripping apart the article point-by-point, but I want to register my support for non-MDs, autonomous NPs in particular, taking over primary care. MDs don't even want to do it anyway!
Latecomer here, but I saw this post and was so infuriated I have to weigh in. This article presents a poorly justified rationale to cover up fear. Maybe nurses aren't doctors, but who says primary care can best be provided by doctors? I don't think this person represents the increasingly more mainstream view: non-doctors are filling a vacuum of primary care left by fleeing MDs--and filling it well. I don't want to spend the time ripping apart the article point-by-point, but I want to register my support for non-MDs, autonomous NPs in particular, taking over primary care. MDs don't even want to do it anyway!
I don't think the author was arguing about not wanting NP to practice as primary care provider. I think he wants them to do that under physician's supervision since NP education is somewhat subpar. One or I can argue that PA model/education is better, but they still have to practice under physician's supervision... I know people here will say NPs have previous experience as a RN, but practicing medicine is different and is on a league of its own... Also, I know people went straight to NP school with no prior nursing experience...
I don't think the author was arguing about not wanting NP to practice as primary care provider. I think he wants them to do that under physician's supervision since NP education is somewhat subpar. One or I can argue that PA model/education is better, but they still have to practice under physician's supervision... I know people here will say NPs have previous experience as a RN, but practicing medicine is different and is on a league of its own... Also, I know people went straight to NP school with no prior nursing experience...
What non-anecdotal evidence do you have the NP education is "subpar"?
merlot sounds good too.
HotHamWater
36 Posts
Right, by exposing the hypocrisy and illogical inconsistencies of one of your more droning colleagues, I've lost credibility for my team (save, there is no team here). That makes about as much sense as him demanding, no less than 10 times, that I defend a position that I've yet not taken. "Where's the evidence to support your position!?" Well, if I had taken position, I'd gladly supply, but....alas. Some real, quality reasoning going on there.
However, I'd love a copy of the talking points you guys seem to be reading from, it's great stuff. You guys are machines, it's as if this stuff has been programed into your heads and you push repeat ad nauseum.